Assessment of effectiveness of existing oncology drug distribution model for the Kenyan market

Abstract

The high mortality due to cancer in developing countries necessitates the development of drug distribution models that ensure effectiveness in delivery and pricing of oncology medication. This need is highlighted by the fact that developing countries like Kenya are most affected by cancer as indicated by the comparative proportion of deaths occurring among such countries. The main objective of the study was to examine the characteristics and effectiveness of existing oncology medicines drug distribution strategies and propose a model for expanding access in the Kenyan market. The study specifically sought to characterize existing oncology drug distribution strategies applied in Kenyan pharmaceutical industry; examine the effectiveness of the strategies based on the experiences and opinions of oncology and pharmaceutical industry experts and finally, develop a model for scaling up drug distribution for oncology medicines in the Kenyan healthcare industry. The study centred on an exploratory research design. Qualitative data was collected from three pharmaceutical firms (Novartis, Roche and Astra Zeneca), two medicines supplies organizations (the Kenya Medical Supplies Authority – KEMSA, and the Mission for Essential Drugs and Supplies – MEDS), and two hospitals serving high volumes of cancer patients (the Kenyatta National Hospital - KNH, a public hospital, and the Texas Cancer Centre – a private hospital. A total of 19 interviews were collected from the organizations. A content analysis approach, centring on transcribed interviews, was employed to address the study objectives. The main contribution of the study presents in highlighting a relatively more efficacious approach to distribution of oncological medicines to the needing population of cancer patients in Kenya. Findings point to three models as most dominant in the market – reduced wholesaler arrangement, direct sales to pharmacies and short-line wholesaling. The models were generally ineffective with respect to rapidity of delivery, continuity of supply and affordability. An ideal model is proposed following an assessment of responses suggesting the need for stakeholder engagement in the crafting of drug distribution models. Findings are of pertinence to policy makers, manufacturers, distributors, payers and patients involved in treatment in the oncology space.